Abstract 9934: Albuminuria Entails Myocardial Fibrosis at the Population Level: The MESA STUDY

Abstract

Introduction: Microalbuminuria(MA) is an established predictor of CVD. Experimental and small observational studies have shown an association between MA and myocardial fibrosis(MF) among patients with type two diabetes mellitus (DM). However, the relationship to MF in a community-based population is unknown. Hypothesis: We hypothesize that participants with MA will have higher rates of MF measured by cardiac magnetic resonance T1(CMR-T1) mapping. Methods: A total of 1,010 men (mean age:68±9) and 1,003 women (mean age: 70 ± 9) who had both urine albumin and creatinine measurements and CMR-T1 for evaluation of MF were included in MESA visit 5. To study the association of MA among various populations, analyses were then stratified by diabetes stage and by sex. Multivariable linear regression models were constructed to assess the associations of MA with ECV and native T1 time. Results: Higher levels of MA were independently associated with greater evidence of MF (Fig.A). Participants with worse severity of MF (defined as ECV >30%), that were men, or had either history of pre-DM or DM had significantly higher levels of MA, whereas no difference in MA levels were found in women (Fig.B). Among men only, each 1-SD increment greater MA levels was significantly associated with 0.3% higher ECV and 2.6% higher native T1. Among participants with pre-diabetes and diabetes, each 1-SD increment in MA levels was associated with 0.4% and 0.3% higher ECV and 3% and 3.5% higher native T1, respectively (Fig.A) Conclusions: In a community-based setting, measurable MA, independent of age, sex, DM, history of CVD, and other clinical variables, was related to subclinical MF. This association was more significant among participants with preDM, Type2DM, and men. These findings demonstrate that MA, a urine biomarker, may identify participants with high subclinical profibrotic condition. Further studies are warranted to address whether treatment of MA will be associated with lower MF.